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Limitations Pre-specified secondary analysis, representing observational data from an RCT Patients were not randomized to SBP groups BP during extended follow up unknown Data may not be generalized to all patients with diabetes

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Summary As expected, diabetic patients with SBP not controlled (140 mm Hg) had the worst outcomes Tight Control (<130 mm Hg) of SBP was not associated with improved CV outcomes compared with Usual Control (130-< 140 mmHg) There was increased risk for mortality in the Tight Control group which persisted during extended follow up SBP <115 mm Hg was associated with an increase in risk for mortality

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Conclusion Is it time to rethink lower BP goals in patients with diabetes and CAD?